Does bleeding after defecation followed by a feeling of discomfort in the anus indicate internal hemorrhoids?

Written by Wu Hai Wu

Gastroenterology

Updated on February 01, 2025

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Bleeding after bowel movements followed by discomfort in the anus may be due to internal hemorrhoids, but could also indicate ulcerative proctitis, rectal cancer, or infections around the anus. To confirm the diagnosis, it is necessary to conduct a thorough examination with a digital colonoscopy. Based on the results of the colonoscopy, appropriate treatment measures can be taken. If the symptoms are caused by internal hemorrhoids, surgical treatment may be considered. For diseases like ulcerative colitis, treatment with salicylate preparations may also be used.

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Written by Deng Heng

Colorectal Surgery

1min 7sec

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How to treat internal hemorrhoids stage II?

Internal hemorrhoids, according to the provisional standards for the diagnosis of hemorrhoids set by the Coloproctology Group of the Surgical Branch of the Chinese Medical Association in September 2002, stage II internal hemorrhoids primarily exhibit symptoms of bleeding during defecation. Additionally, the hemorrhoidal mass prolapses outside the anus during bowel movements but retracts back inside autonomously after defecation. This condition is referred to as stage II internal hemorrhoids, indicating the onset of symptoms like bleeding and prolapse, thus requiring surgical treatment. Indications for surgery include procedures like hemorrhoid banding or hemorrhoidectomy to remove the hemorrhoids. Conservative treatment options like using hemorrhoidal suppositories or ointments are also available if surgery is not immediately considered, but if these treatments are ineffective, surgery should be pursued. (Please use medications under the guidance of a physician to avoid misuse.)

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Written by Deng Heng

Colorectal Surgery

30sec

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The harm of internal hemorrhoids prolapse

Prolapsed internal hemorrhoids are one of the main clinical manifestations of internal hemorrhoids, and their harm is mainly manifested in two aspects: Firstly, the prolapse of hemorrhoidal tissue outside the anus can lead to perianal skin eczema and itching, and anal eczema. Secondly, it can lead to incarcerated hemorrhoids, where the prolapsed internal hemorrhoid, held by the sphincter, forms congestion, and is accompanied by hardening of the hemorrhoidal tissue, pain, and even necrosis.

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Written by Deng Heng

Colorectal Surgery

40sec

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How is internal hemorrhoids bleeding caused?

Internal hemorrhoids bleeding is caused primarily by venous dilation and congestion. Anatomically speaking, hemorrhoids are varicose veins, which means they contain a lot of fresh blood. When straining during defecation, the hemorrhoids rub against the dry stool, causing the mucous membrane of the hemorrhoids to rupture and leading to bleeding symptoms. When the bleeding symptoms are mild, blood can be seen in the stool during defecation, or drops of blood may appear during bowel movements. In severe cases, spraying bleeding may occur. Generally, the bleeding stops after defecation.

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Written by Chen Tian Jing

Colorectal Surgery

53sec

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Can internal hemorrhoids heal on their own?

To determine whether internal hemorrhoids bleeding is self-healing, one should primarily assess the amount of bleeding and the duration of bleeding to further evaluate the severity of the condition. If it is the first occurrence or if the bleeding is mostly noticeable on toilet paper and is relatively minor, self-healing of internal hemorrhoids bleeding can be achieved through lubrication of the stool during defecation and, if necessary, oral administration of cooling blood-stopping medications. However, if the bleeding duration is prolonged, or if the amount of bleeding is significant each time, it is unlikely to achieve complete healing simply through lifestyle adjustments, dietary changes, or even medication. Further surgical ligation and hemostasis treatment may be required for the patient.

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Written by Yu Xu Chao

Colorectal Surgery

1min 18sec

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How to solve internal hemorrhoids that are prolapsed and incarcerated?

In clinical practice, for cases where internal hemorrhoids prolapse and become incarcerated, surgical treatment is often recommended. This is because the prolapse of internal hemorrhoids indicates a significant displacement and that the hemorrhoids have been prolapsed for a long time, which can lead to incarceration. In such cases, there is a risk of localized swelling or thrombosis formation, causing anal swelling and pain, and in severe cases, necrosis of the prolapsed tissue. Therefore, it is advised to opt for surgical treatment as soon as possible for incarcerated internal hemorrhoidal prolapse. Surgical options include hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), and TST (Transanal hemorrhoidal dearterialization) among others. Anesthetic choices can range from local infiltration anesthesia, spinal anesthesia, to general intravenous anesthesia. With spinal and general anesthesia, the patient does not experience pain during surgery and does not feel fear of pain. Post-surgery, it is also necessary to select appropriate medications for dressing changes, such as anal washes, hemorrhoidal suppositories, and golden yellow ointment to promote wound healing.